Thursday, November 15, 2012

We won't let women die, says professor

Eilish O'Reagan, Health Correspondent of the Irish Independent. You can read the article on the Independent's website by clicking here.

A LEADING obstetrician has said doctors do intervene to save the life of a pregnant woman, even if it means the loss of a baby.

Prof Fionnuala McAuliffe said obstetricians who were caring for pregnant women in life-threatening situations were working without specific legislation – but there was "no evidence they are letting people die".

She said obstetricians believed they had the freedom to intervene to save a woman's life, even if it meant the loss of the foetus.

Prof McAuliffe, who works in the National Maternity Hospital in Holles Street, Dublin, said from time to time doctors came across pregnant women who had uncontrollable blood pressure or severe pre-eclampsia, which can lead to severe complications.

"If uncontrollable blood pressure continues, the woman could have a stroke, a brain haemorrhage or die. The only effective way of (avoiding) that is to deliver the baby," she told theIrish Independent.

"If it happens after 24 weeks there is some chance the baby could live. If it is under 24 weeks it will not survive."

Prof McAuliffe, who is spokesperson for the Institute of Obstetricians and Gynaecologists, said obstetricians would welcome legislative clarity.

While the Medical Council's code of ethics states that doctors can intervene to terminate a pregnancy to protect the life of the mother, the institute has not provided any specific guidelines.

Most patients who come to a maternity hospital with threatened miscarriage would want to do everything they could to continue the pregnancy, Prof McAuliffe said.

She said: "the outcomes for pregnant women in Ireland are among the best in the world. We have excellent maternity services. There is no evidence that we are letting patients die to prolong the pregnancy."

Another leading obstetrician, who did not want to be named, said it was his view that doctors were legally protected if they intervened to save the life of a pregnant woman.

Referring to a report that pregnant Savita Halappanavar developed septicaemia, he said a woman could appear relatively well and collapse quickly.

"An infection can creep up on you very quickly without showing great signs. Infection is something that used to kill large numbers of women. It was the greatest cause of maternal mortality.

"It spreads from the vaginal tract up into the womb where the baby is and that is an ideal place for bugs to grow because it is warm and moist."

Rare

A case where a mother developed septicaemia was quite rare and even big maternity hospitals would only see maybe one every two years.

He added: "In my view it is very clear if the mother's life is at risk due to pregnancy continuing you have a choice to bring it to an end. It's very difficult to create guidelines for every individual scenario."

Asked how doctors would respond in the case of a woman who was miscarrying and was in pain, he said that she would be given pain relief.

Dr Peter Boylan, a former master of Holles Street, said doctors would welcome more guidance on when to save the life of a pregnant woman in grey areas where the threat was not dramatic.